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CHILD & ADOLESCENT SYMPTOM INVENTORY-5

(Ages 5 to 18 Years)

By Kenneth D. Gadow, Ph.D. and Joyce Sprafkin, Ph.D.

The Child & Adolescent Symptom Inventory-5 (CASI-5) is a behavior rating scale for DSM-5-defined emotional and behavioral disorders in youths between 5 and 18 years old. There is a parent (173 items, 8 pages) and teacher (125 items, 7 pages) version of the CASI-5. The CASI-5 includes all of the items from both the previously published Child Symptom Inventory-4 (CSI-4) and the Adolescent Symptom Inventory-4 (ASI-4) in a single measure. Furthermore, each symptom category includes an Impairment question (i.e., the degree to which symptoms interfere with the youth’s social or academic functioning).

The CASI-5 replaces the CASI-4R.

The fifth revision to the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) published by the American Psychiatric Association in 2013 resulted in the addition of a few new disorders and in some cases changes in symptoms, names of disorders, or minor alterations in “scoring rules.” Many of these changes are reflected in the CASI-5. Because so many clinicians and researchers are currently using the CASI-4R and some of the DSM-5 revisions are controversial or lack extensive research support, the CASI-5 includes all the original CASI-4R items (with their respective item numbers)to ensure a seamless transition from the CASI-4R to the CASI-5. The CASI-5 can be easily adopted by professionals who are already familiar with the CSI-4, ASI-4, or CASI-4R.

There are nonew norms for the CASI-5 because only one new multi-item disorder (3 or more items) was added to the DSM-5 revision, and the symptoms of the remaining disorders were essentially unchanged.

DISORDERS INCLUDED:
The CASI-5 assesses symptoms of the following disorders: ADHD, oppositional defiant disorder, conduct disorder, generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, disruptive mood dysregulation disorder, major depressive episode, manic episode, dysthymic disorder, schizophrenia, autistic/Asperger’s disorder, anorexia, and bulimia. One or two key symptoms of each of the following disorders are also included: posttraumatic stress disorder, obsessive-compulsive disorder, specific phobia, panic disorder, selective mutism, trichotillomania, motor tics, vocal tics, and substance use.

SCORING:

The CASI-5 is an amalgam of the CSI-4 and the ASI-4, and therefore scoring procedures are highly similar to those for the CSI-4 (children 5 to 12 years in elementary school) and the ASI-4 (youths 12 to 18 year olds in middle, junior or high schools). The CASI-5 can be scored to derive four different scores:

üSymptom Count Cutoff scores based on the number of symptoms necessary for a DSM-5 diagnosis,

üSymptom Severity scores based on a dimensional model that uses normative data to generate T scores,

üImpairment Cutoff scores that indicate whether the youth is impaired by the symptoms of a particular disorder such as ADHD regardless of the youth’s Symptom Count Cutoff score or Symptom Severity score, and

üClinical Cutoff score which is a combination of the DSM-5-referenced Symptom Count Cutoff score and the Impairment Cutoff score.

The CASI-5 uses the same normative data as the CSI-4 and ASI-4 as the bases for T scores. For this reason, there are a few symptom categories for which there are no T scores for a particular age group. For children 5 to 12 years old, there are currently no normative data for the following symptom categories: manic episode, schizophrenia, anorexia, bulimia, or substance use. For youths 12 to 18 years old, there are no normative data or T scores for autistic disorder or Asperger’s disorder.

IMPORTANT: There is currently no Scoring Software for the CASI-5, and there is currently no computer-presented version of the CASI-5.

RESEARCH:

CASI-5 subscale scores generally show a high degree of correspondence with psychiatric diagnoses (predictive validity) and correlate well with other commonly used dimensional scales (concurrent validity). An extensive Annotated Bibliography of research studies that used at least one Checkmate Plus measure can be accessed on the checkmateplus.com website by clicking the “Bibliography of Research” button on the Home page.

PRODUCT FACTS:

New Disorders and Items

• There are several new disorders in the DSM-5 version of the Child and Adolescent Symptom Inventory. They are disruptive mood dysregulation disorder, avoidant/restrictive food intake disorder, binge eating disorder, and social (pragmatic) communication disorder.
• A limited prosocial emotions specifier was added to conduct disorder.
• Three one-item disorders were added to Category E: excoriation disorder (skin picking), trichotillomania (hair pulling), and selective mutism; the latter two disorders appeared in DSM-IV but were not included in the CASI-4R.
• Finally, four new items were added to autism spectrum disorder.

New Item Numbers

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As noted above, the CASI-5 includes all the original CASI-4R items (with their respective item numbers). All new DSM-5-referenced symptom items are denoted with the letter “z.”

There is one new symptom category, disruptive mood dysregulation disorder (Category Rz) and a new specifier for conduct disorder (Category Cz: with limited prosocial emotions).

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New Names for Disorders

Changes to the names of disorders in DSM-5 are as follows: persistent depressive disorder (previously dysthymic disorder), social anxiety disorder (previously social phobia), panic disorder (previously panic attack), and autism spectrum disorder (previously autism and Asperger’s disorder).

Old (DSM-IV) Score Sheets

Because the CASI-4R items and numbering were maintained in CASI-5, all of the CASI-4R score sheets are still valid for DSM-IV-defined disorders. This includes the DSM-IV-referenced Symptom Count Cutoff Score Sheets and the Symptom Severity Profile Score Sheets.

New (DSM-5) Scoring Rules

• To score the CASI-5 according to DSM-5 criteria, you will need the CASI-5Symptom Count Cutoff Score Sheets.
• To highlight disorders for which scoring rules vary according to age (child vs. adolescent), the relevant categories are shaded on the Symptom Count Cutoff Score Sheets.
• The Symptom Severity Profile Score Sheets are the same for the CASI-4R and CASI-5. However, to facilitate scoring, the CASI-5 versions are color-coded based on informant (parent vs. teacher) and age group (child vs. adolescent).

Autism Scoring Rules

The DSM-IV-based scoring rules for autistic disorder and Asperger’s disorder were maintained because DSM-5 states that “individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.” Furthermore, the validity of the autistic disorder and Asperger’s disorder Symptom Count Cutoff and other scoring algorithmshave been validated by extensive research.

Norms

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PRODUCT INFORMATION:

üThe Quick Guide to scoring the Child & Adolescent Symptom Inventory-5 (CASI-5) is included in every order. The Quick Guide describes how to score the CASI-5; however, we recommend that you read either the CSI-4 Screening and Norms Manual or the ASI-4 Screening and Norms Manual for a more detailed description of the development, research, and applications of the Symptom Inventories.

üThe 2002 Child Symptom Inventory 4 Screening and Norms Manual is a 179-page book that reviews DSM-IV diagnostic criteria and describes the development, research, scoring guidelines, normative data, and clinical applications for Symptom Count and Symptom Severity scores. Parallel information for the ASI-4 is provided in the 2008 Adolescent Symptom Inventory 4 Screening and Norms Manual.

üThe CASI-5 Parent Checklist and the CASI-5 Teacher Checklist are sold separately in packages of 50 checklists. CASI-5 Symptom Count Cutoff Score Sheets (25 for children and 25 for adolescents) are included.

üCASI-5 Symptom Severity Profile score sheets can be purchased for the CASI-5 Parent Checklist and the CASI-5 Teacher Checklist. T scores and raw scores are presented separately on the CASI-5 Symptom Severity Profile score sheets by age group (child/adolescent), gender, and informant (parent/teacher). The norms and T scores for the CASI-5 are based on previously-published data for the CSI-4 and ASI-4. Information about the normative samples for the CSI-4 and ASI- 4 can be found on the Products page of the checkmateplus.com website.

TheCASI-5 Deluxe Kit contains the following: 25 CASI-5 Parent Checklists, 25 CASI-5 Teacher Checklists, 25 CASI-5 Symptom Count Cutoff Score Sheets for Children, 25 CASI-5 Symptom Count Cutoff Score Sheets for Adolescents, 50 CASI-5 Symptom Severity Profile score sheets (T scores) for the CASI-5 Parent Checklist (25 for children and 25 for adolescents), 50 CASI-5 Symptom Severity Profile score sheets (T scores) for the CASI-5 Teacher Checklist (25 for children and 25 for adolescents), and both the Child Symptom Inventory-4 Screening and Norms Manual and the Adolescent Symptom Inventory-4 Screening and Norms Manual.

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Revised: January 23, 2016

8-26-2020: CASI is closed until further notice. We thank you for your patience and understanding as we navigate these unprecedented times. Please follow us on Facebook for additional updates on services and programs.

COVID-19 Vaccine Help

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The Center For Active Seniors, Inc. is proud to be a community partner with the Scott County Health Department in the local efforts to put an end to the worldwide COVID-19 pandemic. Beginning on Friday January 29th, CASI will be assisting individuals aged 65 and older who live in Scott County and have limited or no access to the internet with navigating the online registration process for vaccination appointments. Individuals requiring assistance should contact CASI at 563-386-7477.

Due to the large volume of calls we expect, we ask for your patience as we try to assist everyone during this process. Please be aware that due to the current limited supply of the vaccine, limited appointments will be available and no wait list will be created.

The Scott County Health Department vaccine clinic for the week of February 1st is now closed. As has been previously reported, the vaccine is available in extremely limited quantities. CASI has no information on future clinic dates at this time. We will share more information here and with our media partners as more information becomes available through the health department. Due to the incredibly high volume of calls to CASI, we are unable to maintain a wait list at this time. Appointments for future clinics will again be on a first come first serve basis. At CASI, we are acutely aware of how anxious seniors are to receive this potentially life saving vaccine and we are proud to be partnering with this Scott County Health Department on this unprecedented senior health initiative. We are grateful for your understanding, your patience and your grace as we work towards protecting all seniors.

Since 1973, CASI has been serving the needs of older adults. The Center for Active Seniors is more than a place. We're a Cause.

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For over 40 years CASI has stood the test of time, keeping older adults socially, mentally and physically engaged. We accept and embrace our role as the Quad Cities Senior Center and have welcomed the opportunity to grow alongside you.